McGregor PACE Open House Registration

Open House Registration Form

Please complete the form below to register for our August 18 open house event and tell us more about you or your loved one.

Name*
First Last
Company/Affiliation
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Which program are you registering for?*
How did you hear about us?
- Social Media
- Online Search (google, bing, etc)
- Referral (Friends & Family)
- Other
If you selected other, please explain below:
Check here if you would like to receive other program alerts.
- Check here if you would like to receive other program alerts.
Consent*
By submitting this form, I understand and agree that McGregor may contact me via telephone, text/sms, and email regarding my inquiry and that calls and messages may be generated using automated technology.
I agree to the privacy policy.